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HIV Testing Service Utilization Among Transgender Communities: Insights from a Respondent-Driven Sampling Survey in

Rose Pollard Kaptchuk1, Aditya Singh2, Ajay Kumar Reddy2

  • 1The Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA. rosepk@jhu.edu.

AIDS and Behavior
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Summary

Many transgender individuals in India have never tested for HIV due to discrimination and lack of awareness. Addressing psychosocial factors and community support is crucial for improving HIV testing access in transgender populations.

Keywords:
HIV preventionHIV testingIndiaPsychosocial factorsService accessTransgender populations

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Area of Science:

  • Public Health
  • Social Epidemiology
  • Health Disparities

Background:

  • Transgender populations in India face significant HIV burden and discrimination.
  • Limited access to HIV prevention services affects transgender communities.
  • Understanding psychosocial factors is key to improving HIV testing uptake.

Purpose of the Study:

  • To explore psychosocial correlates of HIV testing among transgender individuals in high-HIV burden states in India.
  • To identify reasons for never testing for HIV in this population.
  • To inform targeted HIV testing strategies for transgender communities.

Main Methods:

  • Respondent-driven sampling (RDS) was used to recruit transgender individuals (≥18 years) in Telangana, Maharashtra, and Uttar Pradesh.
  • An interview-administered survey collected data on demographics, psychosocial factors, and HIV testing history.
  • Poisson regression with robust variance was applied to analyze associations with prior HIV testing, incorporating RDS-II weights.

Main Results:

  • Half (47%) of the 1,997 respondents had never tested for HIV.
  • Prior HIV testing was associated with higher/lower risk perception, hazardous alcohol use, sexual violence, larger peer networks, and healthcare stigma.
  • Anxiety or depression was negatively associated with prior HIV testing.
  • Key reasons for never testing included lack of awareness (38%), low risk perception (39%), and privacy concerns (25%).

Conclusions:

  • HIV testing strategies must be gender-identity and psychosocially sensitive to improve access for transgender populations.
  • Community-partnered approaches integrating mental health support and peer networks can enhance HIV testing uptake.
  • Addressing stigma, mental health, and awareness is vital for reducing HIV burden in transgender communities in India.